System or method for calibrating a radiation detection medium

ABSTRACT

Methods and devices for calibrating a radiotherapy system are disclosed. The method includes providing a detection medium that responds to exposure to ionizing radiation, and preparing a calibration dose response pattern by exposing predefined regions of the detection medium to different ionizing radiation dose levels. The method also includes measuring responses of the detection medium in the predefined regions to generate a calibration that relates subsequent responses to ionizing radiation dose. Different dose levels are obtained by differentially-shielding portions of the detection medium from the ionizing radiation using, for example, a multi-leaf collimator, a secondary collimator, or an attenuation block. Different dose levels can also be obtained by moving the detection medium between exposures. The disclosed device includes a software routine fixed on a computer-readable medium that is configured to generate a calibration that relates a response of a detection medium to ionizing radiation dose.

RELATED APPLICATIONS

This continuation application claims the benefit of the followingapplications: utility application Ser. No. 09/872,559 (filed Jun. 1,2001); provisional application No. 60/234,745 (filed Sep. 22, 2000); andprovisional application No. 60/252,705 (filed Nov. 22, 2000).

BACKGROUND OF THE INVENTION

The present invention relates to radiation dosimetry, and moreparticularly to methods and devices for automating radiation dosecalibrations associated with radiotherapy.

An important use of radiotherapy is the destruction of tumor cells. Inthe case of ionizing radiation, tumor destruction depends on the“absorbed dose” or the amount of energy deposited within a tissue mass.Radiation physicists normally express the absorbed dose in cGy units orcentigray. One cGy equals 0.01 J/kg.

Radiation dosimetry generally describes methods to measure or predictthe absorbed dose in various tissues of a patient undergoingradiotherapy. Accuracy in predicting and measuring absorbed dose is keyto effective treatment and prevention of complications due to over orunder exposure to radiation. Many methods exist for measuring andpredicting absorbed dose, but most rely on developing a calibration—acurve or a lookup table—that relates the response of a detection mediumto absorbed dose. Useful detection media include radiation-sensitivefilms and three-dimensional gels (e.g., ‘BANG’ and ‘BANANA’ gels) whichdarken or change color upon exposure to radiation. Other usefuldetection media include electronic portal-imaging devices and amorphoussilicon detector arrays, which generate a signal in response toradiation exposure.

In order to develop a calibration curve or lookup table, discreteportions of the detection medium are exposed to different and knownamounts of radiation using a linear accelerator or similar apparatus.Typically, about twelve, but often as many as twenty-five differentradiation dose levels are measured in order to generate a calibrationcurve or look-up table. Generally, the accuracy of the calibrationincreases as the number of measured radiation dose levels increases.However, measuring separate radiation dose levels is a labor intensiveand time consuming process, which can be demonstrated by examining acalibration process for radiation film dosimetry.

As shown in FIG. 1A and FIG. 1B, a linear accelerator 100 is used toexpose different areas of a radiographic calibration film 102 toionizing radiation 104. The film 102 is typically sandwiched betweenlayers 106 of material that mimic the response of human tissue to theionizing radiation 104. A shield 108, which is made of a dense materialsuch as lead, is interposed between the film 102 and the linearaccelerator 100. The shield 108 has a fixed aperture 110, which onlypermits ionizing radiation 104 to reach an area of the film 102 that isaligned with the aperture 110. During calibration, the area of the film102 that is aligned with the aperture 110 is exposed to a known andunique dose of ionizing radiation 104, while other areas of the film 102are masked by the shield 108. The absorbed dose can be obtained from ionchamber measurements, Fricke dosimetry, calorimetry, or other absolutedosimetry methods. Because of the high radiation levels involved, thephysicist must leave the room and close shielding doors during eachexposure of the film 102. After exposing the film 102 to radiation, thephysicist reenters the room and moves the film 102 to align a previouslyunexposed area of the film 102 with the aperture 110. The physicist thenleaves the room, secures the shielding doors, and sets the linearaccelerator 100 controls to deliver the next dose level. This process isrepeated for each dose level in the calibration sequence.

FIG. 2 shows three radiographic calibration films 102 that have beenexposed to different radiation dose levels during a calibrationsequence. Each of the films 102 have discrete areas 120 that have beenexposed to different radiation dose levels, which range from 0 cGy to220 cGy. Normally, the radiation dose levels of the calibration films102 are obtained throughout a range of dose levels that are expectedduring radiation therapy, and generally range from 0 cGy to as much as6,000 cGy. The step sizes between successive calibration dose levels canvary and depend on the dynamic range of the detection medium used.Ordinarily, the calibration films 102 are scanned with a film digitizer,which converts each of the films to an array of pixels having valuesrepresenting the optical density at each point on a particularcalibration film 102.

FIG. 3 shows a sample calibration or H&D curve 140 obtained from thecalibration films 102 shown in FIG. 2. Usually, specialized softwareaverages the optical density over the discrete areas 120 of thecalibration films 102, and generates a calibration curve or look-uptable based on known values of the radiation dose levels and themeasured optical density. Armed with the H&D curve 140 (or othercalibration), the radiation physicist can quantify beam characteristicsof the linear accelerator through subsequent exposure, development, andoptical density measurements of radiographic films. For example, as partof a treatment plan or quality assurance procedure, the radiationphysicist can use film dosimetry to generate depth dose profiles,isodose and isodensity contours, and cross section profiles. Inaddition, the physicist can use film dosimetry to perform flatness andsymmetry analyses, and to carry out field width calculations, amongothers. Usually, the physicist uses computer software that automaticallycalculates and displays beam characteristics from scanned and digitizedradiographic films. Useful software for generating the H&D curve and foranalyzing radiotherapy beam characteristics includes RIT113 FILMDOSIMETRY SYSTEM, which is available from Radiological ImagingTechnology.

Calibration procedures, such as the method described above for filmdosimetry, have several disadvantages. First, regardless of thedetection media used, the methods require a large number of labor- andtime-intensive steps to expose the requisite dose levels needed togenerate the calibration. Second, care must be taken to ensure that ineach calibration step a previously unexposed area of the detection mediais used. If the dose areas overlap, the calibration data can bemeaningless. Third, because of the relatively large number of films thatmust be exposed in film dosimetry, short-term drift in radiationresponse from one film to the next can occur because of changes in filmprocessor chemistry and temperature.

The present invention overcomes, or at least mitigates, one or more ofthe problems described above.

SUMMARY OF THE INVENTION

One aspect of the invention provides a method for calibrating aradiotherapy system. The method includes providing a detection medium,such as radiographic film, which is adapted to respond to exposure toionizing radiation. The method also includes preparing a calibrationdose response pattern by exposing predefined regions of the detectionmedium to different ionizing radiation dose levels, and measuringresponses of the detection medium in the predefined regions. Thedifferent dose levels are obtained by differentially shielding portionsof the detection medium from the ionizing radiation using, for example,a multi-leaf collimator, a secondary collimator, or an attenuationblock. Usually, the ionizing radiation characteristics (e.g., beamintensity, duration of exposure, etc.) are also changed betweenindividual exposures of the detection medium, causing the delivered doseto vary among different predefined regions. The different dose levelscan also be obtained by moving the detection medium relative to thesource of ionizing radiation between exposures, while changing theionizing radiation characteristics from one exposure to the next. Fromthe measured responses, the method generates a calibration curve orlook-up table that relates the subsequent response of the detectionmedium to ionizing radiation dose.

Another aspect of the invention provides a device for calibrating aradiotherapy system. The device includes a software routine tangiblyembodied or fixed on a computer-readable medium. The software routine isconfigured to generate a calibration that relates a response of adetection medium to ionizing radiation dose. In accordance with theinvention, the software routine generates the calibration from a doseresponse pattern having predefined regions exposed to different ionizingradiation dose levels. The different dose levels are obtained bydifferentially shielding portions of the detection medium from theionizing radiation or by moving the detection medium relative to thesource of ionizing radiation between exposures, while changing theionizing radiation characteristics from one exposure to the next.Generally, the software routine runs on a computer having a graphicaluser interface, which allows interaction between the software routineand the user.

The invention offers significant advantages over conventional,labor-intensive calibration procedures. Because the invention automatesthe calibration process, it significantly reduces the amount of timenecessary to expose a detection medium to different dose levels during acalibration sequence. Additionally, because the dose response pattern ofthe detection medium is highly repeatable and known, computer softwarealgorithms can be used to automatically measure the radiation doseresponse and to automatically generate the calibration curve or look-uptable. Finally, by significantly reducing the number of calibrationfilms or other detection media needed to generate a calibration, theclaimed process has much higher short-term stability. All of theseadvantages should result in better accuracy in radiation dosimetry andimproved patient care.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1A and FIG. 1B show a linear accelerator used to expose differentareas of a radiographic film to ionizing radiation.

FIG. 2 shows three radiographic films that have been exposed todifferent radiation dose levels during a calibration sequence.

FIG. 3 shows a calibration curve (H&D curve), which can be used toconvert optical density of radiographic film to absorbed dose.

FIG. 4 shows a block diagram of an automatic calibration process andsystem for radiation dosimetry.

FIG. 5A through FIG. 5M show multi-leaf collimator (MLC) patterns with2, 4, 6, 8, 10, 12, 14, 16, 18, 20, 22, 24 and 26 leaves open on bothsides, respectively.

FIG. 6 shows the resulting film exposure after executing the multi-leafcollimator patterns in FIG. 5A through FIG. 5M.

FIG. 7 shows a radiation attenuation block for generating radiation doseresponse patterns for radiotherapy calibrations.

DETAILED DESCRIPTION

The present invention generally comprises automatically exposingpredefined areas or regions of a detection medium to known radiationdose levels, and measuring the response of the detection medium to theradiation dose levels. Knowing the response of the detection medium todifferent values of the dose level, one can generate a calibration curveor look-up table. The calibration, which relates the response of thedetection medium to radiation exposure, can then be used to convertsubsequent radiation exposure and response to absorbed dose.

As described below, various techniques and devices can be used toautomatically expose predefined regions of the detection medium todifferent dose levels. One method employs multi-leaf collimators,secondary collimators or fixed blocks of radiation attenuating material,either alone or in combination, to differentially shield the predefinedregions during exposure to ionizing radiation. The ionizing radiationcharacteristics (e.g., beam intensity, individual exposure duration,etc.) can remain unchanged between each exposure, and the delivered dosewill vary among different predefined regions because the detectionmedium is differentially shielded during each exposure. Optionally, thebeam characteristics can vary between one or more of the exposures. Asecond method uses a moveable patient couch or similar apparatus to movethe detection medium relative to the ionizing radiation beam, anddelivered dose is varied between different predefined regions of thedetection medium by changing the ionizing radiation characteristicsbetween exposures.

FIG. 4 shows a block diagram of one embodiment of an automaticcalibration process and system 160 for radiation dosimetry. Thecalibration system 160 shown in FIG. 4 uses a multi-leaf collimator(MLC) to automatically expose predefined areas or regions of a detectionmedium to different and known radiation dose levels. Newer linearaccelerators use multi-leaf collimators for shaping the dose beam duringradiotherapy. A multi-leaf collimator comprises interleaved collimatorsmade of lead (or other high-density material) that move independently inor out of the radiation field to shape the beam. Compared with some leadblocks, multi-leaf collimators allow the radiation physicist to moreclosely tailor the shape of the beam to match the area of the bodyundergoing treatment. Further details concerning multi-leaf collimatorsand shielding blocks can be found in Peter Metcalfe et al., The Physicsof Radiotherapy X-Rays from LinearAccelerators 31-32, 268-72 (1997),which is herein incorporated by reference.

As shown in FIG. 4, the system calibration 160 includes a MLC controllercomputer 162 and a linear accelerator 164 having a multi-leafcollimator. During a calibration sequence, the MLC controller 162provides instructions to a linear accelerator 164 for regulatingradiation beam characteristics and for adjusting positions of individualleaves of the multi-leaf collimator. Through appropriate positioning ofthe leaves, the calibration system 160 automatically (i.e., with minimalhuman intervention) exposes predefined areas or regions of a detectionmedium 166 to known radiation dose levels, which results in a radiationdose response pattern on the detection medium 166. The detection medium166 can be any material or device that will respond in a consistent wayto radiation exposure, and includes radiographic film, 3-D BANG orBANANA gels, amorphous silicon arrays, electron portal imaging devices,and the like. A dosimetry system 168 measures the response of thedetection medium 166 in each of the predefined areas of the detectionmedium 166 and generates a calibration curve or look-up table. For filmdosimetry, the system 168 would likely include a film scanner fordigitizing calibration films, and software running on a computer forgenerating the calibration curve or look-up table and for performingdosimetry calculations. Following subsequent exposure of the detectionmedium—i.e., unexposed test films or gels, amorphous silicon array, andso on—the calibration curve or look-up table can be used to convert theradiation dose response of the detection medium to absorbed dose.

FIG. 5A through FIG. 5M show sample leaf positions of a multi-leafcollimator (MLC) 180 during a calibration sequence. The multi-leafcollimator 180 is comprised of interleaved collimators or leaves 182that move independently in or out of the radiation field 184 from thesides 186, 188 of the MLC 180. FIG. 5A through FIG. 5M show MLC 180patterns with 2, 4, 6, 8, 10, 12, 14, 16, 18, 20, 22, 24 and 26 leaves182 open on both sides 186, 188 of the MLC 180. As noted above,movements of the leaves 182 in FIG. 5A through FIG. 5M, as well as thecharacteristics of the radiation beam (intensity, duration, etc.), arecoordinated by an MLC controller computer based on input by theoperator. Accordingly, the amount of radiation exposure on variouspredefined areas or regions of the detector medium are known or can beobtained by absolute dosimetry (e.g., ionization chamber measurements).

Individual leaves 182 of the multi-leaf collimator 180 respond quicklyto instructions from the MLC controller 162—usually within less thanabout five seconds, and often less than about one second. Individualradiation exposures depend on the dose delivery rate of the radiationsource, the dose response of the detection medium, and the dose levelexpected during radiation therapy. Because commercially available linearaccelerators can typically deliver about 600 cGy per minute, and mostradiotherapies require dose levels less than about 1000 cGy, individualradiation exposures are typically on the order of a few seconds to a fewminutes. Therefore, a twelve-step calibration exposure sequence on asingle film or detection medium ordinarily can be completed in less thanabout five minutes, and usually in less than about two minutes. In somecases, the exposure sequence can be completed in less than about oneminute. In any event, the entire calibration exposure sequence can becompleted in much less than time than conventional processes. Forexample, an operator could generally complete a twelve-step manualcalibration exposure sequence, similar to the one illustrated in FIG. 2,in about forty-five minutes.

FIG. 6 shows a calibration film 200 having a radiation dose responsepattern 202 corresponding to the MLC 180 leaf 182 positions of FIG. 5Athrough FIG. 5M. The calibration film 200 is scanned with a filmdigitizer, which converts the dose response pattern 202 to an array ofpixels having values representing the optical density at each point onthe calibration film 200. Because the dose response pattern 202 isknown, dosimetry software can be used to automatically average theoptical density over each of the predefined areas 204 or regions of thecalibration film 200 (pixel array) and to generate a calibration curveor look-up table. Ordinarily the dosimetry software routine shouldmeasure the dose response away from edges 206 of the predefined areas204 because radiation leakage between the leaves 182 could result inartificially high dose levels.

Dose response patterns besides the step-gradient pattern 202 shown inFIG. 6 can be generated through appropriate programming of the MLCcontroller computer 162 of FIG. 4. For example, the step-gradient doseresponse pattern 202 of FIG. 6 was obtained through multiple exposuresof the predefined areas 204 of the calibration film 200. The beamcharacteristics were not changed between successive exposures of thefilm 200, and differences in optical density among the predefined areas204 of the film 200 resulted from differences in the number of radiationexposures. Other patterns can be obtained by changing the beamcharacteristics between successive exposures. For example, the MLC (orother shielding device) can be used to completely mask areas of thedetector medium so that the dose response pattern resembles FIG. 2. Insuch cases, the beam characteristics—duration, intensity, etc.—arechanged in a predetermined way to effect different radiation doseresponses of the detector medium. Similarly, the beam characteristicscould have been changed between successive exposures of the calibrationfilm 200 shown in FIG. 6.

Other embodiments can include the use of fixed blocks and secondarycollimators (“jaws”) to automatically expose predefined areas or regionsof the detection medium to known radiation dose levels. For example,older linear accelerators and other types of radiation generatingdevices (such as Co-60 sources) can use a fixed block of ionizingradiation attenuating material to create predefined exposure areas. FIG.7 shows one such block 220 having a step pattern 222 that would mimicthe multi-leaf collimator 180 patterns and dose response pattern 202shown in FIG. 5A through FIG. 5M and FIG. 6, respectively. In addition,the secondary collimators of a linear accelerator can be used to achievea similar dose response pattern. Secondary collimators are largeradiation attenuators typically made of lead alloy or tungsten, and canundergo precise movement. On most linear accelerators, the secondarycollimators can be programmed to move to specific locations in order toattenuate the radiation exposure, and can therefore be adapted tosimulate the radiation response pattern 202 of FIG. 6 and others.Whether using fixed blocks or secondary collimators, measurements of theradiation dose response should ordinarily be carried out in areas ofuniform dose exposure, away from any transition regions between thepredefined exposure areas on the detection medium. Further detailsconcerning secondary collimators can be found in Metcalfe et al. at28-29, which is herein incorporated by reference.

Instead of or in addition to regulating the beam exposure pattern bydifferentially shielding the predefined regions of the detection medium,one may automatically expose predefined areas or regions of thedetection medium to known radiation dose levels by moving the detectionmedium between exposures. Referring to FIG. 1, the detection medium(e.g., radiographic calibration film 102) can be placed on a surface 240of a patient couch 242, which is capable of precise, three-dimensionalmotion, including translation and rotation in a plane containing thesurface 240 of the couch 242, and movement perpendicular to the planecontaining the surface 240. During a calibration sequence, a controller(not shown) provides instructions to the linear accelerator 100 forregulating radiation beam 104 characteristics (beam 104 intensity andduration) and for adjusting the position of the patient couch 242 anddetection medium relative to the ionizing radiation beam 104. Thepatient couch 242 can respond quickly to the controller. Depending onthe distanced moved, the patient couch 242 can usually respond withinless than about one minute, and usually less than about five seconds.Therefore, an entire calibration exposure sequence obtained by movingthe detection medium relative to the source of ionizing radiation can becompleted in about the same amount of time as using a multi-leafcollimator, secondary collimator, or attenuation block to regulate thebeam exposure pattern.

Thus, one may obtain a dose response pattern similar to thestep-gradient 202 shown in FIG. 6 by first adjusting the secondarycollimator, the multi-leaf collimator, or the secondary and multi-leafcollimators, to expose a rectangular region of the detection mediumcorresponding to one of the predefined areas 204. Following exposure toionizing radiation 104, the controller moves the patient couch 242 andthe detection medium, and directs the linear accelerator 104 to exposeanother predefined area 204 to a different dose. This process iscontinued until the requisite number of dose levels is obtained.

One may employ other devices for moving the detection medium relative tothe beam 104, such as a computer-controlled x-y coordinate stage that isadapted to displace the detection medium in about one-half mm incrementsor about 0.1-degree arcs. As should be appreciated, one may obtain doseresponse patterns different than the step-gradient 202 shown in FIG. 6by adjusting the shape of the ionizing radiation beam 104 prior to thefirst exposure, and optionally, between successive exposures of thepredefined regions of the detection medium. The shape of the beam 104conforms to the shape of the predefined region or regions during aparticular exposure.

When compared to calibration routines involving multi-leaf collimators,the use of a moving detection medium may provide more accurate delivereddose. Using a secondary collimator instead of a multi-leaf collimator toshape the beam should result in more uniform radiation exposure in eachof the predefined regions of the detection medium. As indicated in thediscussion of FIG. 5A through FIG. 5M, radiation leakage between theleaves 182 of a multi-leaf collimator 180 may result in artificiallyhigh dose levels near the edges 206 of the predefined areas 204 shown inFIG. 6.

In any event, the disclosed automatic calibration processes and systemsfor radiation dosimetry provide significant advantages over conventionalmethods and devices. As noted above, the disclosed processes cancomplete a calibration exposure sequence in much less time and with muchless operator intervention than conventional labor-intensive calibrationmethods. In addition, as described in the background section,conventional dose response patterns on film depend on the manualplacement of the film, resulting in an arbitrary spatial distribution.Consequently, in conventional calibration exposure processes thedosimetry software user must specify the location of each area of thefilm (pixel array) that corresponds to a specific dose level.

Although it may be possible to develop computer software algorithms thatcan automatically locate the different exposure regions inconventionally exposed films, such routines will be comparatively muchmore difficult to implement because the dose response pattern is unknownand varies from film to film. Unlike conventional calibration techniquesand devices, the use of a MLC or similar attenuating device allows oneto obtain dose response data using a single calibration film ordetection medium because of the precise spatial arrangement of the doseresponse pattern. Thus, for example, the automated calibration methodsand devices allow one to obtain dose response patterns having ten,twenty, thirty, forty, and fifty or more different dose levels on asingle detection medium such as a radiographic film.

As noted above, radiation physicists typically use computer softwarethat automatically calculates and displays calibration curves, look-uptables, and beam characteristics from the dose response patterns.Software routines generally control positions of primary, secondary, andmulti-leaf collimators, and also adjust the position of the patientcouch. Thus, portions of the disclosed calibration methodology aretypically implemented as software routines that run on a processor.Suitable processors include, for example, both general and specialpurpose microprocessors. Typically, the processor receives instructionsand data from a read-only memory and/or a random access memory. Computerinstructions and data are loaded into the read-only memory and/or therandom access memory from a storage device or computer readable medium.Storage devices suitable for tangibly embodying computer programinstructions and data include all forms of non-volatile memory,including, for example, semiconductor memory devices, such as EPROM,EEPROM, and flash memory devices; magnetic disks such as internal harddisks and removable disks; magneto-optical disks; and CD-ROM, CD-R andCD-RW disks. One may supplement any of the foregoing by, or incorporatein, ASICs (application-specific integrated circuits).

To provide interaction with a user, one can implement portions of thecalibration methods on a computer system having devices for displayinginformation to the user and for allowing the user to input informationto the computer system. Useful display devices include a monitor and LCDscreen; suitable input devices include a keyboard, which can be usedwith a pointing device such as a pressure-sensitive stylus, a touch pad,a mouse or a trackball. In addition, the computer system may provide agraphical user interface through which the computer routines interactwith the user.

The above description is intended to be illustrative and notrestrictive. Many embodiments and many applications besides the examplesprovided would be apparent to those of skill in the art upon reading theabove description. The scope of the invention should therefore bedetermined, not with reference to the above description, but shouldinstead be determined with reference to the appended claims, along withthe full scope of equivalents to which such claims are entitled. Thedisclosures of all articles and references, including patentapplications and publications, are incorporated by reference for allpurposes.

1-17. (Canceled)
 18. A calibration system for a radiotherapyapplication, comprising: a detection medium, said detection mediumincluding a plurality of predefined regions, wherein said detectionmedium provides for the absorption of a plurality of doses; a linearaccelerator, said linear accelerator configured to expose said pluralityof predefined regions to said plurality of doses, said plurality ofdoses including a plurality of dose levels, with each said dose being ofone said dose level; a plurality of measured responses resulting fromthe exposure of said detection medium to said plurality of doses; and acalibration generated from said plurality of measured responses on saiddetection medium.
 19. The system of claim 18, wherein the number ofdoses is equal to the number of predefined regions, and wherein eachpredefined region is exposed to only one dose.
 20. The system of claim19, wherein said dose level is different for each said predefinedregion.
 21. The system of claim 18, wherein said detection medium isexposed to a said plurality of doses in a sequence of doses, and whereinsaid plurality of predefined regions are exposed one at a time withinsaid sequence.
 22. The system of claim 21, wherein no human interventionoccurs during said sequence.
 23. The system of claim 18, wherein saidplurality of measured responses are analyzed in a sequence ofmeasurements, and wherein said plurality of measured responses areanalyzed individually within said sequence.
 24. The system of claim 23,wherein no human intervention occurs during said sequence.
 25. Thesystem of claim 18, wherein said calibration is not specific to aparticular patient.
 26. The system of claim 18, wherein said calibrationis calculated from a sequence of at least six doses, and wherein anelapsed time for calculating said calibration from said detection mediumis less than approximately ten minutes.
 27. The system of claim 18,wherein said calibration represents a relationship between said linearaccelerator and said detection medium.
 28. The system of claim 18,wherein said plurality of measured responses are displayed in the formof a step-gradient pattern. 29-37. (Canceled)